Validation of AshTest as a Non-Invasive Alternative to Transjugular Liver Biopsy in Patients with Suspected Severe Acute Alcoholic Hepatitis
According to guidelines, the histological diagnosis of severe alcoholic steatohepatitis (ASH) can require liver biopsy if a specific treatment is needed. The blood test AshTest (BioPredictive, Paris, France) has been initially validated for the non-invasive diagnosis of ASH in a large population of...
Gespeichert in:
| Veröffentlicht in: | PloS one 2015-08, Vol.10 (8), p.e0134302-e0134302 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0134302 |
|---|---|
| container_issue | 8 |
| container_start_page | e0134302 |
| container_title | PloS one |
| container_volume | 10 |
| creator | Rudler, Marika Mouri, Sarah Charlotte, Frederic Cluzel, Philippe Ngo, Yen Munteanu, Mona Lebray, Pascal Ratziu, Vlad Thabut, Dominique Poynard, Thierry |
| description | According to guidelines, the histological diagnosis of severe alcoholic steatohepatitis (ASH) can require liver biopsy if a specific treatment is needed. The blood test AshTest (BioPredictive, Paris, France) has been initially validated for the non-invasive diagnosis of ASH in a large population of heavy drinkers. The aim was to validate the AshTest accuracy in the specific context of use of patients with suspected severe ASH, in order to reduce the need for transjugular biopsy before deciding treatment.
The reference was liver biopsy, performed using the transjugular route, classified according to its histological severity as none, minimal, moderate or severe. Biopsies were assessed by the same experienced pathologist, blinded to simultaneous AshTest results.
A total of 123 patients with severe clinical ASH (recent jaundice and Maddrey function greater or equal to 32) were included, all had cirrhosis and 80% had EASL histological definition of ASH. 95% of patients received prednisolone; and the 2-year mortality was 63%. The high AshTest performance was confirmed both for the binary outcome [AUROC = 0.803 (95%CI 0.684-0.881)] significantly higher than the AST/ALT AUROC [0.603 (0.462-0.714); P |
| doi_str_mv | 10.1371/journal.pone.0134302 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1702213163</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A432850745</galeid><doaj_id>oai_doaj_org_article_d260eeb816cb4d83b8d8efeefce7b1f9</doaj_id><sourcerecordid>A432850745</sourcerecordid><originalsourceid>FETCH-LOGICAL-c726t-5c9805644a488e1704b2f1321bd9c5eb8b04c7a91e4937a1ba05fec8507d88b23</originalsourceid><addsrcrecordid>eNqNk11v0zAUhiMEYmPwDxBYQkLsosVf-bpBKhPQShVDtOzWcpyTxpUbd7FT2H_gR-Os2dROu0C5SHTyvO-xX_tE0WuCx4Sl5OPadm0jzXhrGxhjwjjD9El0SnJGRwnF7OnB90n0wrk1xjHLkuR5dEITGtOUsNPo75U0upRe2wbZCk1cvQTnkXRIou-2Gc2anXR6B2hiPIR-vv_2Fi1b2bh1t-qMbNE8FFv0Wdutu0G6QT8CBo136Lf2NVp0bgvKQ4kWELhgpTrfGypbW6MVmsI2CLx2L6NnlTQOXg3vs-jX1y_Li-lofvltdjGZj1RKEz-KVZ7hOOFc8iwDkmJe0IowSooyVzEUWYG5SmVOgOcslaSQOK5AZTFOyywrKDuL3u59t8Y6MQTpRHCilDCSsEDM9kRp5VpsW72R7Y2wUovbgm1XQrZeKwOipAmG0JQkquBlxoqszKACqBSkBany4PVp6NYVGyhVSKaV5sj0-E-ja7GyO8FjmhMSB4PzvUH9QDadzEVfw4TSGGO-I4H9MDRr7XUXjlJstFNgjGzAdrd7ZDQY0zSg7x6gjycxUCsZNqubyoY1qt5UTDijfai8X-L4ESo8JWy0Cje00qF-JDg_EgTGwx-_kp1zYrb4-f_s5dUx-_6ArUEaXztruv6Cu2OQ70HVWudaqO6TJVj0A3aXhugHTAwDFmRvDg_zXnQ3Uewfd0cg5g</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1702213163</pqid></control><display><type>article</type><title>Validation of AshTest as a Non-Invasive Alternative to Transjugular Liver Biopsy in Patients with Suspected Severe Acute Alcoholic Hepatitis</title><source>Public Library of Science (PLoS) Journals Open Access</source><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Free E-Journal (出版社公開部分のみ）</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Rudler, Marika ; Mouri, Sarah ; Charlotte, Frederic ; Cluzel, Philippe ; Ngo, Yen ; Munteanu, Mona ; Lebray, Pascal ; Ratziu, Vlad ; Thabut, Dominique ; Poynard, Thierry</creator><creatorcontrib>Rudler, Marika ; Mouri, Sarah ; Charlotte, Frederic ; Cluzel, Philippe ; Ngo, Yen ; Munteanu, Mona ; Lebray, Pascal ; Ratziu, Vlad ; Thabut, Dominique ; Poynard, Thierry</creatorcontrib><description>According to guidelines, the histological diagnosis of severe alcoholic steatohepatitis (ASH) can require liver biopsy if a specific treatment is needed. The blood test AshTest (BioPredictive, Paris, France) has been initially validated for the non-invasive diagnosis of ASH in a large population of heavy drinkers. The aim was to validate the AshTest accuracy in the specific context of use of patients with suspected severe ASH, in order to reduce the need for transjugular biopsy before deciding treatment.
The reference was liver biopsy, performed using the transjugular route, classified according to its histological severity as none, minimal, moderate or severe. Biopsies were assessed by the same experienced pathologist, blinded to simultaneous AshTest results.
A total of 123 patients with severe clinical ASH (recent jaundice and Maddrey function greater or equal to 32) were included, all had cirrhosis and 80% had EASL histological definition of ASH. 95% of patients received prednisolone; and the 2-year mortality was 63%. The high AshTest performance was confirmed both for the binary outcome [AUROC = 0.803 (95%CI 0.684-0.881)] significantly higher than the AST/ALT AUROC [0.603 (0.462-0.714); P<0.001], and for the severity of ASH-score system by the Obuchowski measures for [mean (SE) 0.902 (0.017) vs. AST/ALT 0.833 (0.023); P = 0.01], as well as for the diagnosis and severity of ballooning, PMN and Mallory bodies. According to attributability of discordances, AshTest had a 2-7% risk of 2 grades misclassification.
These results confirmed the diagnostic performance of AshTest in cirrhotic patients with severe clinical ASH, in the specific context of use of corticosteroid treatment. AshTest is an appropriate non-invasive alternative to transjugular liver biopsy.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0134302</identifier><identifier>PMID: 26252713</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acute Disease ; Alcohol ; Ashes ; Balloon treatment ; Biomarkers ; Biopsy ; Blood tests ; Care and treatment ; Cirrhosis ; Complications and side effects ; Corticosteroids ; Diagnosis ; Diagnostic systems ; Female ; Hepatitis ; Hepatitis, Alcoholic - diagnosis ; Hepatitis, Alcoholic - pathology ; Hepatology ; Histology ; Human health and pathology ; Humans ; Jaundice ; Life Sciences ; Liver ; Liver - pathology ; Liver cirrhosis ; Liver diseases ; Male ; Medical diagnosis ; Middle Aged ; Patient outcomes ; Patients ; Prednisolone ; Prognosis ; Reproducibility of Results ; Risk factors ; ROC Curve ; Systematic review</subject><ispartof>PloS one, 2015-08, Vol.10 (8), p.e0134302-e0134302</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Rudler et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Attribution</rights><rights>2015 Rudler et al 2015 Rudler et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c726t-5c9805644a488e1704b2f1321bd9c5eb8b04c7a91e4937a1ba05fec8507d88b23</citedby><cites>FETCH-LOGICAL-c726t-5c9805644a488e1704b2f1321bd9c5eb8b04c7a91e4937a1ba05fec8507d88b23</cites><orcidid>0000-0002-6865-3791</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529115/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529115/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26252713$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.sorbonne-universite.fr/hal-01225004$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Rudler, Marika</creatorcontrib><creatorcontrib>Mouri, Sarah</creatorcontrib><creatorcontrib>Charlotte, Frederic</creatorcontrib><creatorcontrib>Cluzel, Philippe</creatorcontrib><creatorcontrib>Ngo, Yen</creatorcontrib><creatorcontrib>Munteanu, Mona</creatorcontrib><creatorcontrib>Lebray, Pascal</creatorcontrib><creatorcontrib>Ratziu, Vlad</creatorcontrib><creatorcontrib>Thabut, Dominique</creatorcontrib><creatorcontrib>Poynard, Thierry</creatorcontrib><title>Validation of AshTest as a Non-Invasive Alternative to Transjugular Liver Biopsy in Patients with Suspected Severe Acute Alcoholic Hepatitis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>According to guidelines, the histological diagnosis of severe alcoholic steatohepatitis (ASH) can require liver biopsy if a specific treatment is needed. The blood test AshTest (BioPredictive, Paris, France) has been initially validated for the non-invasive diagnosis of ASH in a large population of heavy drinkers. The aim was to validate the AshTest accuracy in the specific context of use of patients with suspected severe ASH, in order to reduce the need for transjugular biopsy before deciding treatment.
The reference was liver biopsy, performed using the transjugular route, classified according to its histological severity as none, minimal, moderate or severe. Biopsies were assessed by the same experienced pathologist, blinded to simultaneous AshTest results.
A total of 123 patients with severe clinical ASH (recent jaundice and Maddrey function greater or equal to 32) were included, all had cirrhosis and 80% had EASL histological definition of ASH. 95% of patients received prednisolone; and the 2-year mortality was 63%. The high AshTest performance was confirmed both for the binary outcome [AUROC = 0.803 (95%CI 0.684-0.881)] significantly higher than the AST/ALT AUROC [0.603 (0.462-0.714); P<0.001], and for the severity of ASH-score system by the Obuchowski measures for [mean (SE) 0.902 (0.017) vs. AST/ALT 0.833 (0.023); P = 0.01], as well as for the diagnosis and severity of ballooning, PMN and Mallory bodies. According to attributability of discordances, AshTest had a 2-7% risk of 2 grades misclassification.
These results confirmed the diagnostic performance of AshTest in cirrhotic patients with severe clinical ASH, in the specific context of use of corticosteroid treatment. AshTest is an appropriate non-invasive alternative to transjugular liver biopsy.</description><subject>Acute Disease</subject><subject>Alcohol</subject><subject>Ashes</subject><subject>Balloon treatment</subject><subject>Biomarkers</subject><subject>Biopsy</subject><subject>Blood tests</subject><subject>Care and treatment</subject><subject>Cirrhosis</subject><subject>Complications and side effects</subject><subject>Corticosteroids</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Female</subject><subject>Hepatitis</subject><subject>Hepatitis, Alcoholic - diagnosis</subject><subject>Hepatitis, Alcoholic - pathology</subject><subject>Hepatology</subject><subject>Histology</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Jaundice</subject><subject>Life Sciences</subject><subject>Liver</subject><subject>Liver - pathology</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Middle Aged</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Prednisolone</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>Risk factors</subject><subject>ROC Curve</subject><subject>Systematic review</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11v0zAUhiMEYmPwDxBYQkLsosVf-bpBKhPQShVDtOzWcpyTxpUbd7FT2H_gR-Os2dROu0C5SHTyvO-xX_tE0WuCx4Sl5OPadm0jzXhrGxhjwjjD9El0SnJGRwnF7OnB90n0wrk1xjHLkuR5dEITGtOUsNPo75U0upRe2wbZCk1cvQTnkXRIou-2Gc2anXR6B2hiPIR-vv_2Fi1b2bh1t-qMbNE8FFv0Wdutu0G6QT8CBo136Lf2NVp0bgvKQ4kWELhgpTrfGypbW6MVmsI2CLx2L6NnlTQOXg3vs-jX1y_Li-lofvltdjGZj1RKEz-KVZ7hOOFc8iwDkmJe0IowSooyVzEUWYG5SmVOgOcslaSQOK5AZTFOyywrKDuL3u59t8Y6MQTpRHCilDCSsEDM9kRp5VpsW72R7Y2wUovbgm1XQrZeKwOipAmG0JQkquBlxoqszKACqBSkBany4PVp6NYVGyhVSKaV5sj0-E-ja7GyO8FjmhMSB4PzvUH9QDadzEVfw4TSGGO-I4H9MDRr7XUXjlJstFNgjGzAdrd7ZDQY0zSg7x6gjycxUCsZNqubyoY1qt5UTDijfai8X-L4ESo8JWy0Cje00qF-JDg_EgTGwx-_kp1zYrb4-f_s5dUx-_6ArUEaXztruv6Cu2OQ70HVWudaqO6TJVj0A3aXhugHTAwDFmRvDg_zXnQ3Uewfd0cg5g</recordid><startdate>20150807</startdate><enddate>20150807</enddate><creator>Rudler, Marika</creator><creator>Mouri, Sarah</creator><creator>Charlotte, Frederic</creator><creator>Cluzel, Philippe</creator><creator>Ngo, Yen</creator><creator>Munteanu, Mona</creator><creator>Lebray, Pascal</creator><creator>Ratziu, Vlad</creator><creator>Thabut, Dominique</creator><creator>Poynard, Thierry</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-6865-3791</orcidid></search><sort><creationdate>20150807</creationdate><title>Validation of AshTest as a Non-Invasive Alternative to Transjugular Liver Biopsy in Patients with Suspected Severe Acute Alcoholic Hepatitis</title><author>Rudler, Marika ; Mouri, Sarah ; Charlotte, Frederic ; Cluzel, Philippe ; Ngo, Yen ; Munteanu, Mona ; Lebray, Pascal ; Ratziu, Vlad ; Thabut, Dominique ; Poynard, Thierry</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c726t-5c9805644a488e1704b2f1321bd9c5eb8b04c7a91e4937a1ba05fec8507d88b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acute Disease</topic><topic>Alcohol</topic><topic>Ashes</topic><topic>Balloon treatment</topic><topic>Biomarkers</topic><topic>Biopsy</topic><topic>Blood tests</topic><topic>Care and treatment</topic><topic>Cirrhosis</topic><topic>Complications and side effects</topic><topic>Corticosteroids</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Female</topic><topic>Hepatitis</topic><topic>Hepatitis, Alcoholic - diagnosis</topic><topic>Hepatitis, Alcoholic - pathology</topic><topic>Hepatology</topic><topic>Histology</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Jaundice</topic><topic>Life Sciences</topic><topic>Liver</topic><topic>Liver - pathology</topic><topic>Liver cirrhosis</topic><topic>Liver diseases</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Middle Aged</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Prednisolone</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>Risk factors</topic><topic>ROC Curve</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rudler, Marika</creatorcontrib><creatorcontrib>Mouri, Sarah</creatorcontrib><creatorcontrib>Charlotte, Frederic</creatorcontrib><creatorcontrib>Cluzel, Philippe</creatorcontrib><creatorcontrib>Ngo, Yen</creatorcontrib><creatorcontrib>Munteanu, Mona</creatorcontrib><creatorcontrib>Lebray, Pascal</creatorcontrib><creatorcontrib>Ratziu, Vlad</creatorcontrib><creatorcontrib>Thabut, Dominique</creatorcontrib><creatorcontrib>Poynard, Thierry</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale in Context : Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database (ProQuest)</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>ProQuest - Health & Medical Complete保健、医学与药学数据库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database (Proquest)</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Database (1962 - current)</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>Biological Sciences</collection><collection>Agriculture Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest advanced technologies & aerospace journals</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rudler, Marika</au><au>Mouri, Sarah</au><au>Charlotte, Frederic</au><au>Cluzel, Philippe</au><au>Ngo, Yen</au><au>Munteanu, Mona</au><au>Lebray, Pascal</au><au>Ratziu, Vlad</au><au>Thabut, Dominique</au><au>Poynard, Thierry</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Validation of AshTest as a Non-Invasive Alternative to Transjugular Liver Biopsy in Patients with Suspected Severe Acute Alcoholic Hepatitis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-08-07</date><risdate>2015</risdate><volume>10</volume><issue>8</issue><spage>e0134302</spage><epage>e0134302</epage><pages>e0134302-e0134302</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>According to guidelines, the histological diagnosis of severe alcoholic steatohepatitis (ASH) can require liver biopsy if a specific treatment is needed. The blood test AshTest (BioPredictive, Paris, France) has been initially validated for the non-invasive diagnosis of ASH in a large population of heavy drinkers. The aim was to validate the AshTest accuracy in the specific context of use of patients with suspected severe ASH, in order to reduce the need for transjugular biopsy before deciding treatment.
The reference was liver biopsy, performed using the transjugular route, classified according to its histological severity as none, minimal, moderate or severe. Biopsies were assessed by the same experienced pathologist, blinded to simultaneous AshTest results.
A total of 123 patients with severe clinical ASH (recent jaundice and Maddrey function greater or equal to 32) were included, all had cirrhosis and 80% had EASL histological definition of ASH. 95% of patients received prednisolone; and the 2-year mortality was 63%. The high AshTest performance was confirmed both for the binary outcome [AUROC = 0.803 (95%CI 0.684-0.881)] significantly higher than the AST/ALT AUROC [0.603 (0.462-0.714); P<0.001], and for the severity of ASH-score system by the Obuchowski measures for [mean (SE) 0.902 (0.017) vs. AST/ALT 0.833 (0.023); P = 0.01], as well as for the diagnosis and severity of ballooning, PMN and Mallory bodies. According to attributability of discordances, AshTest had a 2-7% risk of 2 grades misclassification.
These results confirmed the diagnostic performance of AshTest in cirrhotic patients with severe clinical ASH, in the specific context of use of corticosteroid treatment. AshTest is an appropriate non-invasive alternative to transjugular liver biopsy.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26252713</pmid><doi>10.1371/journal.pone.0134302</doi><orcidid>https://orcid.org/0000-0002-6865-3791</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2015-08, Vol.10 (8), p.e0134302-e0134302 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1702213163 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Free E-Journal (出版社公開部分のみ）; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acute Disease Alcohol Ashes Balloon treatment Biomarkers Biopsy Blood tests Care and treatment Cirrhosis Complications and side effects Corticosteroids Diagnosis Diagnostic systems Female Hepatitis Hepatitis, Alcoholic - diagnosis Hepatitis, Alcoholic - pathology Hepatology Histology Human health and pathology Humans Jaundice Life Sciences Liver Liver - pathology Liver cirrhosis Liver diseases Male Medical diagnosis Middle Aged Patient outcomes Patients Prednisolone Prognosis Reproducibility of Results Risk factors ROC Curve Systematic review |
| title | Validation of AshTest as a Non-Invasive Alternative to Transjugular Liver Biopsy in Patients with Suspected Severe Acute Alcoholic Hepatitis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T09%3A00%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Validation%20of%20AshTest%20as%20a%20Non-Invasive%20Alternative%20to%20Transjugular%20Liver%20Biopsy%20in%20Patients%20with%20Suspected%20Severe%20Acute%20Alcoholic%20Hepatitis&rft.jtitle=PloS%20one&rft.au=Rudler,%20Marika&rft.date=2015-08-07&rft.volume=10&rft.issue=8&rft.spage=e0134302&rft.epage=e0134302&rft.pages=e0134302-e0134302&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0134302&rft_dat=%3Cgale_plos_%3EA432850745%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1702213163&rft_id=info:pmid/26252713&rft_galeid=A432850745&rft_doaj_id=oai_doaj_org_article_d260eeb816cb4d83b8d8efeefce7b1f9&rfr_iscdi=true |